Rural town banded together to open a hospital. Its foe? A larger hospital.

By Jack Healy and Eve Edelheit

Published
12:53 pm PDT, Wednesday, September 5, 2018

IMMOKALEE, Fla. — Not long after Beau Braden moved to southwest Florida to open a medical clinic, injured strangers started showing up at his house. A boy who had split open his head at the pool. People with gashes and broken bones. There was nowhere else to go after hours, they told him, so Braden stitched them up on his dining room table.

They were 40 miles inland from the coral-white condos and beach villas of Naples, but Braden said that this rural stretch of Collier County, with tomato farms and fast-growing exurbs, had fewer hospital beds per person than Afghanistan.

So when he proposed starting a 25-bed rural hospital to serve the 50,000 people who live in the farming town of Immokalee and the nearby planned community of Ave Maria, people rallied to the idea. They envisioned a place where mothers could give birth and sick children could get 24-hour help — their own novel solution to an exodus of hospital care from rural America.

But then this summer, a larger hospital in Naples derailed those plans by asking the state to deny the proposal, saying that the small, rural hospital would siphon away patients and revenue. The move has upended people’s hopes around Immokalee and delayed any plans to start building the hospital for months. Maybe for good.

“It’s just horribly mean,” Braden said.

Rural communities across the country are suffering the effects of hospital closures because of shrinking populations, financial strains and corporate consolidations. Since 2010, 87 rural hospitals have closed.

But as Braden learned, even when a town wants to open a new hospital to make up for the loss in care, the challenges can be enormous. Just to open the doors, rural hospital projects need to raise millions of dollars for construction, equipment and salaries for doctors and nurses. They need to woo highly trained staff to out-of-the way towns. They must thread a maze of regulations without an army of experts and high-priced consultants, which are available to larger hospitals.

Florida is one of 35 states with laws aimed at preventing too many hospitals from being built in the same area, or having too many hospital beds and redundant services. Supporters have to convince the state they are building something necessary. Without a certificate of need, the project cannot get off the ground.